Only a few states have developed mechanisms to authorize medical decisions on behalf of incapacitated unrepresented patients. California's was recently struck down as unconstitutional. In contrast, one of New York's mechanisms is expanding,

The Justice Center for the Protection of People with Special Needs administers the Surrogate Decision-Making Committee (SDMC) program for New York State. The SDMC program obtains informed consent for non-emergency major medical care procedures and in some cases end-of-life decision making by or on behalf of persons with mental disabilities, living in State-operated or State-licensed mental hygiene residential programs, who have no legal surrogates.

The Justice Center just published a Request for Proposals to establish contracts that will cover the five-year period November 1, 2015 through October 31, 2020 to provide SDMC administrative support services for various regions across New York.